��������Ƶ

1. Group Coverage Terms: Used when the policy covers multiple individuals under a group plan

2. International Coverage: Included when the policy provides coverage for treatment abroad

3. Pre-existing Conditions: Specific terms for pre-existing conditions when covered

4. Maternity Benefits: Details of maternity coverage when included in the policy

5. Dental and Vision Coverage: Terms for dental and vision benefits if offered

6. Premium Waiver Provisions: Conditions under which premium payments may be waived

7. Network Providers: Terms specific to in-network and out-of-network coverage

1. Schedule A - Benefits Table: Detailed breakdown of coverage limits, deductibles, and co-payments

2. Schedule B - Premium Schedule: Detailed premium calculations and payment schedules

3. Schedule C - Network Providers: List of approved healthcare providers and facilities

4. Schedule D - Claim Forms: Standard forms required for claim submission

5. Appendix 1 - Pre-approval Procedures: List of treatments requiring pre-approval and procedures

6. Appendix 2 - Emergency Procedures: Guidelines for emergency treatment and claims

7. Appendix 3 - Privacy Policy: Detailed privacy and data protection policies